Provider Demographics
NPI:1588415285
Name:NAVA, PRISCILLA MARIE
Entity type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:MARIE
Last Name:NAVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6628 SAN MARCUS ST
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-3024
Mailing Address - Country:US
Mailing Address - Phone:818-416-3083
Mailing Address - Fax:
Practice Address - Street 1:7700 IMPERIAL HWY STE A
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-3466
Practice Address - Country:US
Practice Address - Phone:323-538-9050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician